الفهرس 
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Abstract
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia resulting from insulin resistance and insufficiency which may be associated with a wide range of complications if untreated such as nephropathy, retinopathy, neuropathy and also increase the risk of cardiovascular disease.
One major cause of morbidity and mortality in persons with diabetes is diabetic nephropathy, which is the leading cause of chronic kidney disease (CKD) and end-stage renal disease worldwide.
Copeptin, the C-terminal fragment of arginine vasopressin prohormone represents the release of AVP and is considered to be a reliable surrogate marker for AVP. Copeptin has shown association with development of chronic kidney disease (CKD) in people with diabetes. Early detection of individuals having the highest risk could help avoid this complication.
The current study aimed to determine the association of plasma copeptin, a surrogate of vasopressin, with the incidence of diabetic nephropathy in Type 2 diabetes mellitus.
The study was conducted at the internal medicine and clinical pathology departments of Benha University Hospitals from November 2018 to May 2019 on 60 patients with diabetes mellitus type 2 and 20 apparently healthy subjects serving as a control group .
Patients were further subdivided into two groups : (group I) Diabetic patients with nephropathy and (group II) Diabetic patients without nephropathy.
All patients and controls were subjected to full history taking and clinical examination . In addition to laboratory investigations including Complete blood picture , fasting blood glucose , HbA1c, serum creatinine, serum urea, estimated glomerular filtration rate (eGFR), Urinary albumin mg/g creatinine (Albumin creatinine ratio) and quantification of Copeptin in serum.
The results of the present work showed that :-
•No significant difference of sex distribution among the studied groups.
•No significant variations were detected between the age of different groups.
•There was no significant variation found between diabetic patients with and without nephropathy.
•No significant variations were detected between different study groups regarding consanguinity.
•BMI was significantly higher in the diabetic groups when compared to control group and it showed significant increase between diabetics without nephropathy compared to diabetics with nephropathy.
•Systolic blood pressure and diastolic blood pressure were significantly higher in diabetics with and without nephropathy compared to control group.
•Fasting blood glucose level & HbA1C were significantly higher in diabetic patients with and without nephropathy compared to control group.
•No significant variations were found between study groups regarding complete blood count indices regarding TLC , platelets.
•There was a highly significant decrease in hemoglobin (Hb) in diabetic patients (with or without nephropathy) compared to control group.
•Serum urea was significantly higher in diabetic patients with nephropathy and diabetic patients without nephropathy when compared to control group.
•Serum creatinine was significantly higher in diabetic patients with nephropathy and diabetic patients without nephropathy when compared to control group.
•There was a significant decrease in estimated glomerular filtration rate (eGFR) in diabetic patients with nephropathy and diabetic patients without nephropathy compared to control group.
•urinary albumin creatinine ratio (ACR) was significantly increased in diabetic patients with nephropathy and diabetic patients without nephropathy compared to control group.
•There was a significant increase in serum copeptin level in diabetic patients with nephropathy when compared to diabetic patients without nephropathy and control group.
•There was positive significant correlation between serum copeptin level and fasting blood sugar, HbA1c, serum creatinine and urinary albumin / creatinine ratio(ACR) in diabetic patients with nephropathy.
•There was negative significant correlation between serum
copeptin level and age , BMI and eGFR diabetic patients with nephropathy•Diabetic patient without nephropathy with copeptin level ≥ 43.4 Pmol/L is predicted to have nephropathy, sensitivity is 70%, specificity is 66.7%, AUC=0.666 with 95%CI=0.53-0.81.
•Copeptin ≥ 43.4 Pmol/L is a significant predictor of diabetic nephropathy among diabetic patients type 2 (P<0.05).